Laserfiche WebLink
Wisconsin Department of Safety and Professional Services Page of <br /> Division of Industry Services 65 -1 n' <br /> SOIL EVALUATION REPORT <br /> In accordance with SPS 385,Wis. Adm. Code County Q !^h <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, <br /> but not limited to:vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D.07 D(r—d-39-4 -A1-/O/—eiCo <br /> scale or dimensions,north arrow,and location and distance to nearest road. -- C/ 700 <br /> Please print all information. Re ewed b Da <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 07' I VD" <br /> Property Owner Property Location 12 <br /> 3 4.30h P e,v'1 r e i Govt.Lot 1/4 ''A S J T 3/ N R /& E (or) W <br /> Property Owner's Mailing Address Lot# 7 Block# Subd.Name ori M# <br /> ?o01),3-- 116-1,,e.. weed i4t.r V..L R)) <br /> City State Zip Code Phone br 0 Nurn <br /> S{'1�L�er jV111/ j"s©7LI JJ�� City ❑Village ©Town Nearest Road 1.5-9 53y <br /> I (f, ) ys' ,t I I /rleeriC!11 I /ehv.5eri i? <br /> Ei New Construction Use:It Residential/Numberof bedrooms of Code derived design flow rate)00 GPD <br /> 0 Replacement 0 Public or commercial—Describe: <br /> / <br /> Parent material 11 4G! .I Or 1 tFlood Plan elevation if applicable �� ft. <br /> General comments and recommendations: s rs t'f✓• ' 5 <br /> 1 Boring# 0 Boring %7 _ _ <br /> [4 Pit Ground surface elev. ft. Depth to limiting factor-5 S in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. <br /> *Eff#1 *Eff#2 <br /> / o— L( 7,5.4 R.34. /S /#4456 A m I C S 3 iti , 7 / 6 <br /> d. '7-3"3- `7,sL1/z // — /F_5 , ,m s6/< /n / (r 5 3c ,-s— AO <br /> 3 >S 65 7-FIR WA, Ci,d_ iiz7- ,fJ )msbk Ail / — .},rI, .--5J A 0 <br /> 0 Boring ,r� <br /> Boring# W Pit Ground surface elev.9� ft. Depth to limiting factor-5 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 <br /> 1 0 —LI 7, ,i - 4 /5 /r.3 6/e- /1, / G 3 r►'? .7 7. 6 <br /> d. ti-33 7,5yiz "'Al /FS AI'»s6 k ,n I 65 3e ,,,r /.o <br /> 3 j 3- (00 7•-tL1/2`l/y Ghc(- 79, IgS ),#-.150( 1ti1 1 )41'1 ,3 /'e <br /> *Effluent#1 =BOD,>30<_220 mg/L and TSS>30 5 150 mg/L *Effluent#2=BOD,>30<_220 mg/L and TSS>30 5 150 mg/L <br /> CST Name(Please Print) 'l aSignatu S /.)a CST0u7,74-41 <br /> ,7y J� 6 <br /> %-)IX � � <br /> ,� 3 � r�e1 S <br /> Address /-774a /7 y 3.5 Date valuation Conducted Telephone Number <br /> /4/-(65 7,,,,- 1I 57.1Sra13 S---/--?0)0 7'5 9'6 - 4-/0'7 <br /> SBD-8330(R04/15) <br />